Over the past few years there has been increasing interest in the importance of spirituality for those in the fourth age of life in care settings. The emphasis on person‐centred approaches has led to recognition of spiritual needs as well as the need for spiritual assessment and care planning. In this paper we reflect on what makes life worth living at different stages, and review the spiritual needs of the fourth age in relation to those inner needs with which many of us would identify.We suggest that several approaches are required in order to understand and meet the spiritual needs of people in the fourth age. While a person‐centred approach is essential, much can also be gained from a broader understanding that places the older person in the context of the wider community. Spiritual and other needs may be met through addressing social inclusion.If we are to properly understand and meet the spiritual needs of those in the fourth age, both in the community and in care settings, we need a new paradigm. The insights and practice tools developed in other areas (through the Valuing People and social inclusion agendas) could provide a useful framework to assist in meeting the spiritual needs of the fourth age. This paper aims to contribute to, and extend, the debate about meeting spiritual needs of people in care settings.
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